Pain Isn’t Always Obvious Suicide Is Preventable KNOW THE SIGNS MEDIA ANALYSIS Final Report PUBLISHED BY ADEASE EDUCATION DEVELOPMENT CENTER, INC. YOUR SOCIAL MARKETER, INC. JUNE 2014 Funded through Counties by the voter approved Mental Health Services Act (Prop. 63) and overseen by the California Mental Health Services Authority (CalMHSA). suicide is preventable.org MEDIA ANALYSIS - FINAL REPORT EXECUTIVE SUMMARY Know the Signs implemented a three-pronged approach to increase California’s news media adherence to the Recommendations: • direct outreach to media with the Recommendations; • education for messengers with “Making Headlines: A Guide to Engaging the Media in Suicide Prevention in California” and two webinars to introduce it; • a series of eight forums to reach messengers and media representatives. We then sought to measure how well California-based newspaper reporting adhered to the Recommendations and whether there were changes after the period of most intensive intervention. Eight of our 11 hypotheses were supported by the findings which show the potential of educating both the media and suicide prevention spokespeople. • There was an increase in the percentage and total number of articles covering the topic of suicide prevention, and a decrease in the percentage of articles that addressed only addressed a suicide death or attempt. • The percentage of articles that provided a suicide prevention resource increased by almost threefold. • The percentage of articles that discussed the method of a specific suicide death/attempt, including the weapon used and graphic details, decreased by more than 50%. • The percentage of articles that used more appropriate language (“killed himself,” “died by suicide”) to describe suicide doubled. • We did not see a large shift in quotes by or interviews with suicide prevention experts and saw a slight decrease in quotes by mental health professionals. However, the 2013 analysis showed a greater diversity in the roles of people who were quoted, and a decrease in interviews with family members of decedents, who often are not versed in prevention messaging. • In addition, we found more articles that had been written by suicide prevention practitioners or spokespeople themselves or who were cited as “special contributors”. 2 TABLE OF CONTENTS Purpose 5 The Impact of Media Contagion 5 Intervention 5 1: Reaching the media directly with the Recommendations 6 2: Messenger education 6 3: Forums reaching messengers and the media 6 Hypotheses 7 Method of analysis 7 Sample size 7 Summary of findings 8 Observations & Discussion 10 Conclusion 11 Next Steps 11 Chart 1: Topics covered 12 Chart 2: Resources provided 13 Chart 3: Information on “How to Help” 15 Chart 4: Warning signs and risk factors for suicide 16 Chart 5: Quotes and references 18 Chart 6: Single event or condition preceding suicide 19 Chart 7: Information on location of suicide 20 Chart 8: Information about suicide method 21 Chart 9: Suicide note 22 Chart 10: Language used to describe suicide 23 Chart 11: Sensational language 24 Appendix 1: Newspapers represented in sample 25 Appendix 2: Timeline 26 4 MEDIA ANALYSIS - FINAL REPORT Purpose The California Suicide Prevention Social Marketing Campaign (“KTS”)1, funded by counties through the voter-approved Mental Health Services Act (Proposition 63) and administered by the California Mental Health Services Authority (CalMHSA), sought to improve how news media cover suicide deaths and prevention activities throughout the state. In order to determine whether improvements were made, we analyzed news reports at Baseline (2011) and Follow-Up (2013) to determine whether KTS educational outreach interventions to agency representatives, suicide prevention experts, and journalists regarding best practices for reporting on suicide increased adherence to the established consensus recommendations for reporting on suicide. The baseline report “Media analysis” can be found in the Resource Center of Your Voice Counts under Data and Reports. The Impact of Media Contagion2 As the Baseline Media Analysis described, the news media can have a powerful influence on how the public perceives suicide. Appropriate reporting can relay accurate facts, raise awareness about suicide prevention, and educate the public on resources and treatment options. When suicides are not reported appropriately, the media can indirectly transmit suicide contagion, the process by which one suicide becomes a compelling model for successive suicides (Gould, 2001). Such coverage can also perpetuate myths such as the belief that suicides cannot be prevented, or reinforce barriers to seeking help. The consensus Recommendations for Reporting on Suicide, last revised in 2011 (www.reportingonsuicide.org), provide suggestions to the news media on how to address suicide. Intervention Know the Signs campaign staff3 implemented a three-pronged approach to increase California’s news media adherence to the Recommendations. Our first goal was to ensure that reporters, editors and producers were aware of the Recommendations as a necessary first step toward implementing them. We also wanted to educate community messengers who might be called upon for interviews and comments, and encourage them to conduct outreach to their local media to increase coverage of their suicide prevention activities. 1. Learn more about Know the Signs, the California Suicide Prevention Social Marketing Campaign, at www.suicideispreventable.org. 2. For more information on the research behind media contagion, please refer to the Baseline Media Analysis Report, 2011, available in the Resource Center of Your Voice Counts www.yourvoicecounts.org 3. Sandra Black, Anara Guard, and Theresa Ly, working at the time for EDC, Inc., a subcontractor to AdEase. 5 MEDIA ANALYSIS - FINAL REPORT 1: Reaching the media directly with the Recommendations We reached out to a number of journalism organizations, requesting that they run articles and post online about the Recommendations. The most responsive were: • Reporting on Health: November 2012. Posted article on website in reaching over 2,000 members • California Newspaper Publishers Association: December 2012. Printed article in quarterly bulletin sent to daily and weekly newspapers thoughout the state • California Broadcasters Association: Distributed a brief article to their 1000+ member stations In addition, any time that a media representative contacted KTS, our response routinely provided the Recommendations. This method reached a number of journalists, including the Executive Editor of the Sacramento Bee, Orange County Register, Cal State Fullerton Daily Titan, KZFR-FM, KTLK-AM, Capital Public Radio, and the Free Your Mind radio program. 2: Messenger education In October 2012, KTS published “Making Headlines: A Guide to Engaging the Media in Suicide Prevention in California” which was disseminated to all 58 county behavioral health agencies. This guide provides individuals and organizations engaged in suicide prevention with tools to generate media coverage and skills to act as effective spokespeople. The guide also includes a copy of the Recommendations. Two webinars were held the following month to introduce the guide with attendees from 37 counties participating. One webinar was designed for small, rural and frontier counties. 3: Forums reaching messengers and the media Eight media forums involving over 300 individuals were convened throughout California4 from September 2012 to September 2013. Each forum engaged community and agency messengers along with media representatives about how to adhere to the Recommendations, develop partnerships with the media, and craft suicide prevention messages. The forum content presented by KTS staff was based on the Making Headlines toolkit and centered on the two simple concepts of “Do No Harm” and “Promote Prevention” as well as offering additional messaging and reporting tactics. Media representation included San Diego Union-Tribune, San Diego and Coronado Patch, KOGO radio, North County Times, East County Magazine, Univision, Stockton Record, Truckee Tahoe Radio, Sacramento News & Review, Sierra Sun, and others. We also presented a workshop to future journalists through the Journalism Association of Community Colleges. 4. Los Angeles, Sacramento, San Diego, San Joaquin, Superior Region, and Tahoe-Truckee area 6 MEDIA ANALYSIS - FINAL REPORT Hypotheses KTS hypothesized that this three-pronged approach to improving media adherence to the Recommendations for Reporting on Suicide would affect the content of news coverage in these ways: • Increase the number and proportion of news articles that: – Cover suicide prevention topics (Hypothesis 1) – Share suicide prevention resources (Hypothesis 2) – Share information on how to help someone who is experiencing thoughts of suicide (Hypothesis 3) – Mention at least one warning sign or risk factor (Hypothesis 4) – Quote a suicide prevention or mental health expert (Hypothesis 5) • Decrease the number and proportion of news articles that: – Imply a single cause or condition preceded a suicide death or attempt (Hypothesis 6) – Specify the location where a death or attempt occurred (Hypothesis 7) – Specify the method of a suicide death or attempt (Hypothesis 8) – Describe the contents of a suicide note (Hypothesis 9) – Use inappropriate language to describe suicide (Hypothesis 10) – Use sensational language to describe suicide epidemiology (Hypothesis 11) Note that we did not propose to change the number of reports on suicide deaths. Such reporting